Role of neck dissection for metastatic nonseminomatous testicular carcinoma: case report and literature review

Abstract

To review the incidence, treatment and prognosis of testicular carcinoma metastatic to the neck, and to propose a selective neck dissection be performed for residual disease post-chemotherapy. A 17-year-old young man with metastatic testicular carcinoma presented with a left neck mass. A palpable neck mass is the initial sign in approximately 5 per cent of cases of metastatic testicular teratoma. Approximately 30 per cent of patients with advanced-stage testicular cancer have extra-retroperitoneal disease post-chemotherapy, which requires resection. The presented patient underwent a left selective neck dissection, thymectomy, median sternotomy, left thoracotomy and mediastinal lymph node dissection. Eighteen months later, a computed tomography scan of the thorax showed no evidence of disease recurrence in the neck or mediastinum. While surgical management of testicular cancer retroperitoneal metastases is well described, there is limited literature on the management of cervical lymph node metastases. In the presented case of metastatic testicular carcinoma with cervical lymph node metastases, a selective neck dissection was successfully performed for a post-chemotherapy mass.